Regis Eric Maia Barros1, João Mazzoncini de Azevedo Marques2, Jair Lício Ferreira Santos2, Antonio Waldo Zuardi3, Cristina Marta Del-Ben3. 1. Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto-USP, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Ribeirão Preto, SP, CEP: 14048-900, Brazil. regisbarros@usp.br. 2. Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. 3. Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto-USP, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Ribeirão Preto, SP, CEP: 14048-900, Brazil.
Abstract
PURPOSE: This study aims to verify the impact that the length of stay has on the rates of readmission for patients who were first admitted to various inpatient psychiatric units in a large catchment area in a middle-income country. METHODS: The study included all patients who were first admitted to the 108 acute psychiatric beds available in the catchment area of Ribeirão Preto, Brazil, for a period of 8 years. Demographic features, inpatient unit of discharge, diagnosis and length of stay were assessed by bivariate analysis. An analysis of the time span between first admission and readmission was also conducted using survival curves estimated by the Kaplan-Meier formula. For the analyses of the risk of readmissions, a logistic regression analysis was conducted. RESULTS: From a total of 6261 patients admitted in the period of the survey, approximately one-third (2006) had at least one other readmission during the follow-up period. The rates per year of early readmission (within 90 days after discharge) varied from 16.1 to 20.9 %. The risk of readmission was higher immediately after discharge. The survival analysis showed that ultrashort length of stay (1-2 days) was associated with reduced odds of readmission, but multivariate logistic analysis showed no association between length of stay and the odds of readmissions. The predictors of early readmission included the diagnosis of depressive, bipolar, psychotic, and non-alcohol-related disorders, younger ages and unemployment. CONCLUSIONS: Duration of the first psychiatric admission was not associated with a higher risk of readmissions. Predictors for early readmissions of first-time-admitted psychiatric patients seem to be more related to the severity of the psychiatric diagnosis and demographic characteristics.
PURPOSE: This study aims to verify the impact that the length of stay has on the rates of readmission for patients who were first admitted to various inpatient psychiatric units in a large catchment area in a middle-income country. METHODS: The study included all patients who were first admitted to the 108 acute psychiatric beds available in the catchment area of Ribeirão Preto, Brazil, for a period of 8 years. Demographic features, inpatient unit of discharge, diagnosis and length of stay were assessed by bivariate analysis. An analysis of the time span between first admission and readmission was also conducted using survival curves estimated by the Kaplan-Meier formula. For the analyses of the risk of readmissions, a logistic regression analysis was conducted. RESULTS: From a total of 6261 patients admitted in the period of the survey, approximately one-third (2006) had at least one other readmission during the follow-up period. The rates per year of early readmission (within 90 days after discharge) varied from 16.1 to 20.9 %. The risk of readmission was higher immediately after discharge. The survival analysis showed that ultrashort length of stay (1-2 days) was associated with reduced odds of readmission, but multivariate logistic analysis showed no association between length of stay and the odds of readmissions. The predictors of early readmission included the diagnosis of depressive, bipolar, psychotic, and non-alcohol-related disorders, younger ages and unemployment. CONCLUSIONS: Duration of the first psychiatric admission was not associated with a higher risk of readmissions. Predictors for early readmissions of first-time-admitted psychiatricpatients seem to be more related to the severity of the psychiatric diagnosis and demographic characteristics.
Entities:
Keywords:
Length of stay; Mental health services; Psychiatric emergency; Psychiatric readmission
Authors: Paulo Rossi Menezes; Cristina Marta Del-Ben; Daiane Leite da Roza; Marcos Gonçalves de Rezende; Régis Eric Maia Barros; João Mazzoncini de Azevedo-Marques; Jair Lício Ferreira Santos; Lilian Cristina Correia Morais; Carlos Eugenio de Carvalho Ferreira; Bernadette Cunha Waldvogel Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2022-05-31 Impact factor: 4.328
Authors: M E S B Santos; D L Roza; R E M Barros; J L F Santos; D Razzouk; J M Azevedo-Marques; P R Menezes; C M Del-Ben Journal: Braz J Med Biol Res Date: 2021-07-23 Impact factor: 2.590